Treatment of glenohumeral instability in rugby players

Rugby is a high-impact collision sport, withimpact forces. Shoulder injuries are common and resultin the longest time off sport for any joint injury in rugby.The most common injuries are to the glenohumeral jointwith varying degrees of instability. The degree of instabilitycan guide management. The three main types of instabilitypresentations are: (1) frank dislocation, (2) subluxationsand (3) subclinical instability with pain and clicking.Understanding the exact mechanism of injury can guidediagnosis with classical patterns of structural injuries. Thestandard clinical examination in a large, muscular athletemay be normal, so specific tests and techniques are neededto unearth signs of pathology. Taking these factors intoconsideration, along with the imaging, allows a treatmentstrategy. However, patient and sport factors need to be alsoconsidered, particularly the time of the season and stageof sporting career. Surgery to repair the structural damageshould include all lesions found. In chronic, recurrentdislocations with major structural lesions, reconstructionprocedures such as the Latarjet procedure yields better outcomes.Rehabilitation should be safe, goal-driven and athlete-specific. Return to sport is dependent on a number offactors, driven by the healing process, sport requirements and extrinsic pressures